The Story of Inhaled Insulin (So Far)

imagesToday, the number of diabetic patients is increasing day by day across the globe. According to the facts & figures published by the International Diabetes Federation, 642 million people will be suffering from diabetes by 2040. Diabetes patients contribute nearly one third of health care costs under the Sun.

A lot of studies on diabetes have concluded that glucose control can help to stabilize life expectancy and it can also improve the quality of life.

In the year 1921, a group of physicians started to inject insulin on the body of the patients suffering from diabetes. A few years later, people thought of inventing the concept of inhaled insulin rather than injecting them.

Yes, you have heard it right. You can inhale insulin. So, this article is for the people who are not yet aware of this development in the field of medicines. Read the entire article to know more about the story of Inhaled insulin.

The Idea

Many attempts have been made to create new ways of delivering insulin other than injections. Scientists tried to control the insulin through nasal passage or by mouth. The lining of the gastrointestinal track and the nasopharynx are impassable in nature. The most capable way of giving insulin was through deep lung, wherein the insulin is readily absorbed by the body.

Thus, the scientists brought out a way wherein the insulin could be inhaled. During the early 2000’s, there were nearly 7 types of inhaled insulin available.

Around 118 studies were carried out which included 48 large Phase 3 studies and 16000 patients who used the benefits of inhaled insulin.

Invention of Exubera

While the scientists were carrying out an investigation on inhaled insulin, it was found that it leads to the emergence of the so-called Exubera. Exubera was invented by Nektar Therapeutics, a San Francisco based scientist. It became the first kind of inhaled insulin product to be marketed in 2006 by Pfizer (a giant Pharmaceutical Company).

Exubera was designed for adults who suffered from Type 1 and Type 2 Diabetes in US and EU during 2006. In a study done by Dr. Marcia Testa of Harvard School of Public Health revealed that inhaling Exubera was widely accepted by diabetes patients, when compared to injecting insulin.

The end result of using inhaled insulin was decreased burden, painless process, great flexibility, convenience and widely accepted by society. Most of the patients loved it as it was budget-friendly and was available at a low price.

The fall of Exubera

In 2006, FDA accepted Exubera, which was made by the giant Pharma – Pfizer. It was the only inhaling insulin available in the market, when Pfizer decided to call it off.

Despite the popularity received in the market, Exubera proved too expensive for Pfizer to handle. It was revealed that people who used Exubera are more likely prone to lung cancer. In a clinical trial conducted among 4740 patients, 6 patients of the control group developed lung cancer. The device used to deliver Exubera was expensive and awkward, thus was not liked by most of the diabetes patients.

Emergence of Afreeza

With the downfall of Exubera in the market, the scope for other insulin inhalers emerged. In February 2015, new inhaled insulin named Afreeza was brought into the market. It was brought out by CA-based MannKind Corp. The company MannKind Corp. was created by a medical entrepreneur named Alfred Mann.

The dosing cartridges of Afreeza are based on colors such as 4 units (blue), 8 units (green) and 12 units (yellow) doses. The inhaler is disposable in nature and they should be replaced once in two weeks.

Afreeza also adopts a different method to formulate the insulin. Afreeza is controlled with the help of a small device named Dreamboat.

Though it is available in a powder form, it has the capability to deliver the insulin into the arterial blood system rather than capillary system. The dry powder used in Afreeza is made up of Technosphere Insulin. It is composed of insulin and proprietary units called Technosphere. It penetrates deeper into the lungs and shows immediate effect.

Afreeza works within 10 to 15 minutes and is pumped out of the system within an hour. The other insulin available in the market usually takes 15 to 20 minutes and is thrown out of the system, nearly after 2 hours.

Afreeza is made for people suffering from Type 1 and Type 2 diabetes. They should consume it before their meals. It is generally considered to be a substitute for injectable insulin. The most common negative effect of taking Afreeza is developing a cough.

In the clinical trials, people consuming Afreeza were at a higher risk of developing Diabetic Ketoacidosis (DKA), which has life-threatening properties. But, Afreeza does not develop any sort of cancer, especially lung cancer.

Afreeza might create a slight complication while breathing. The pulmonary function should be monitored in patients who are consuming this drug. It may increase the level of anti-insulin antibodies more than treating with injectable insulin.

In 2015, Sanofi merged with MannKind Corp to develop a market for Afreeza. But within a year, it disappointed the sales by causing Sanofi to terminate the partnership. It led to the downfall of Afreeza.

Dance Pharmaceuticals

While Pharma companies were competing for developing inhaled insulin, Dance Pharmaceuticals emerged with a similar concept. It was a low-cost product which had the potential to please all the patients in the market. It is small, simple and easy to use. It matches the human body physically and naturally.

Risk of Inhaling Insulin

  • Inhaled Insulin is not recommended for smokers.
  • It can have long term effects on the lungs.
  • People using inhaled insulin can experience cough.
  • It has other ill effects also.

Future of Inhaled Insulin

Inhaled insulin has a great scope in the long run future. It has become a widely accepted way of intaking insulin among the diabetes patients. Today, the inhaled insulin is also being tested for use in the Artificial Pancreas System to control the blood and glucose levels.

Yet, nothing can be clearly predicted about the story of inhaled insulin. The future of inhaled insulin is still being written and over-written. We have to wait till the clear results are out.

Sources:

http://www.idf.org/about-diabetes/facts-figures

http://dancebiopharm.com/the-story-of-inhaled-insulin/

http://www.how22.com/showinfo-1036-15348-0.html

http://www.bmj.com/content/320/7246/1373.full

Posted in Cure for Diabetes.

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